Kimberly Ruiz Dizon, MHS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56200 Issued in CA

Practice address

1530 E Hammer LN
Stockton, CA 95210

Phone

(209) 954-3200

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Flores Ruiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1942633318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103149",
            "telephone_number": "099-543-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95210",
            "telephone_number": "209-954-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9516 Coney Island Cir",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957583646",
            "country_code": "US",
            "telephone_number": "510-375-4778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1530 E Hammer Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "95210",
            "country_code": "US",
            "telephone_number": "209-954-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIZON",
        "first_name": "KIMBERLY",
        "middle_name": "RUIZ",
        "credential": "MHS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RUIZ",
            "middle_name": "FLORES",
            "credential": "BS, CNIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael V Dixon, P.A.
• Omolade Nikkita Dixon
• Stella Alexandria Dixon
• Timothy A Dixon, MD
• Jena Mae Dizon
• Djamshid Moshirnia, M.D., Inc.
• Dorothy Hong DO-Williams, M.D.
• Andrew DO, PHARMD
• Khang DO
• Luat DO

• Physician Assistant in Stockton, CA
• Providers in Stockton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.